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Experience with the ketogenic diet in infants
D R Nordli1, M M Kuroda, J Carroll
1Epilepsy Center, Children's Memorial Hospital, Chicago, Illinois, USA. dnordli@childrensmemorial.org
Insights
The ketogenic diet is a safe and effective treatment for infants with intractable epilepsy, showing significant seizure reduction and improved behavior. Most infants tolerated the diet well, with reversible adverse events.
Area of Science:
- Pediatric Neurology
- Metabolic Therapies
- Epilepsy Management
Background:
- Refractory epilepsy in infants poses significant management challenges.
- Limited treatment options exist for infants with intractable seizures.
Purpose of the Study:
- To assess the efficacy, tolerability, and safety of the ketogenic diet in infants with refractory epilepsy.
- To evaluate the impact of the ketogenic diet on seizure frequency, behavior, and medication use.
Main Methods:
- Retrospective review of 32 infants treated with the ketogenic diet.
- Analysis of ketosis maintenance, seizure reduction, adverse events, and parental-reported outcomes.
Main Results:
- 71% of infants achieved strong ketosis.
- 19.4% became seizure-free; 35.5% had >50% seizure reduction.
- Significant improvements in behavior, attention, and socialization were reported.
- The diet was well-tolerated with appropriate growth maintained in 96.4% of patients.
Conclusions:
- The ketogenic diet is a safe and effective therapeutic option for infants with intractable seizures.
- Consideration of the ketogenic diet is warranted for this population.
- Further research into long-term outcomes and specific epilepsy syndromes is beneficial.
Objective:
To evaluate the effectiveness, tolerability, and adverse effects of the ketogenic diet in infants with refractory epilepsy.
Methods:
A retrospective review of 32 infants who had been treated with the ketogenic diet at a large metropolitan institution.
Results:
Most infants (71%) were able to maintain strong ketosis. The overall effectiveness of the diet in infants was similar to that reported in the literature for older children; 19.4% became seizure-free, and an additional 35.5% had >50% reduction in seizure frequency. The diet was particularly effective for patients with infantile spasms/myoclonic seizures. There were concomitant reductions in antiepileptic medications. The majority of parents reported improvements in seizure frequency and in their child's behavior and function, particularly with respect to attention/alertness, activity level, and socialization. The diet generally was well-tolerated, and 96.4% maintained appropriate growth parameters. Adverse events, all reversible and occurring in one patient each, included renal stone, gastritis, ulcerative colitis, alteration of mentation, and hyperlipidemia.
Conclusion:
The ketogenic diet should be considered safe and effective treatment for infants with intractable seizures.